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Home Affordable Care Act Individual Healthcare Mandate Being Considered in Maryland [UPDATE]

Individual Healthcare Mandate Being Considered in Maryland [UPDATE]

2 minute read
by Robert Sheen

Senate Republicans added repeal of the ACA’s individual mandate to the Senate’s tax reform bill to save nearly $340 billion in federal funds during the next decade to mitigate increases to the federal deficit. The savings result from the federal government not having to pay premium tax credits (PTCs) to help low-income individuals and families offset the cost of securing healthcare insurance on government exchanges to comply with the individual mandate. The Congressional Budget Office (CBO) estimates that the effect of repealing the individual mandate would be to increase by another 13 million more in uninsured Americans.

The Maryland Health Insurance Coverage Protection Commission was formed to study the potential impact of federal health care reform on Maryland. Its members include representatives from across the health care industry and state legislators. The group reviewed several ideas to address consequences to the state’s insurance market caused by a repeal of the ACA individual mandate, including replacing it with a state mandate. Since that time, some members of the state legislature have proposed legislation that would establish an individual mandate for health insurance for Maryland resident.

Here’s what’s proposed:

  • Starting in 2020, when uninsured Marylanders file state tax returns they will receive notice that their money will be used as a down-payment to help them buy health insurance, unless they would rather pay a penalty for not having insurance.
  • Maryland Health Connection (MHC), the state’s health exchange, already offers health insurance that costs no more than the down-payment plus federal tax credits for which the uninsured consumers qualify. MHC will enroll the consumer in a health insurance plan if there is zero additional cost.
  • If MHC cannot find a zero-cost plan, the consumer’s payment is held in an interest bearing, “escrow” account to buy insurance during the next open enrollment period.
  • If the consumer does not select a plan by the end of open enrollment, MHC checks to see whether a zero-cost plan has become available. If so, the consumer is enrolled in that plan by default.
  • The consumer can use the down-payment only through the end of open enrollment. After that, a “use it or lose it” rule applies, and unused down-payments go into a health insurance stabilization fund.
  • Medicaid will cover uninsured Marylanders whose tax returns demonstrate Medicaid eligibility.

If passed, Maryland would join Massachusetts in having its own state individual healthcare insurance mandate. Massachusetts’ individual mandate had been adopted in 2006 prior to the ACA’s enactment.

In a poll conducted by OpinionWorks for Citizen’s Health Initiative, a state healthcare advocacy group, 65% of Maryland residents were actually in favor of the ACA’s individual mandate; 52% in favor of a state-specific individual mandate.

Vincent DeMarco, president of Citizens’ Health Initiative and a member of the state commission, is a proponent of establishing a state individual mandate. “There keep being threats to the individual mandate and other things in the ACA,” DeMarco told local news site Maryland Matters. “The conventional wisdom is that it’s the least popular part of the ACA, and people don’t want it. But in Maryland, they do.”

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Individual Healthcare Mandate Being Considered in Maryland [UPDATE]
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Individual Healthcare Mandate Being Considered in Maryland [UPDATE]
While Republicans in Congress have repealed the Affordable Care Act’s individual mandate effective 2019 in final tax reform legislation, the state of Maryland is considering implementing its own healthcare mandate for its state residents.
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The ACA Times
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